Kim L Grata, CADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Twin Falls, ID

NPI 1336738574 · NPPES record last updated Jan 12, 2021

Key facts

NPI
1336738574
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
630 Addison Ave W Ste 1000
Twin Falls, ID 83301-5853
Phone
(208) 736-5048
Fax
(208) 735-2126
NPI assigned
Jan 12, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Falls County Current
since Jan 17, 2021
Accepting new patients
Mountain West Behavioral Health Past Accepting new patients

Locations

630 Addison Ave W
Ste 1000
Twin Falls, ID 83301
Phone (208) 736-5048

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

630 Addison Ave W Ste 1000
Twin Falls, ID 83301-5853

Mailing address

630 Addison Ave W Ste 1000
Twin Falls, ID 83301-5853
Phone (208) 736-5048

Other identifiers

IdentifierTypeStateIssuer
I1709684MedicaidID

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address kim.grata@twin-falls.id.us

Other providers in Twin Falls, ID

All providers in Twin Falls, ID · Addiction (Substance Use Disorder) Counselor in Idaho

Sources for this page

Verify at the official NPI Registry.